Young adults’ management of Type 1 diabetes during life transitions

Authors

  • Bodil Rasmussen,

    1. Authors: Bodil Rasmussen, PhD, RN, Senior Lecturer and Course Coordinator of Graduate Certificate of Diabetes Education and Master Courses, School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University; Glenn Ward, MBBS, DPhil, Sc, Associate Professor and Head of Diabetes Services, Departments of Endocrinology and Diabetes and Clinical Biochemistry, St Vincent’s Hospital; Alicia Jenkins, MBBS, MD, Associate Professor, Department of Endocrinology and Diabetes, University of Melbourne and Physician, St Vincent’s Hospital; Susan J King, PhD, BN, RN, Research Fellow, School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University; Trisha Dunning, PhD, AM, Professor and Inaugural Chair in Nursing, Barwon Health and Deakin University, Geelong and School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University and Barwon Health, Vic., Australia
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  • Glenn Ward,

    1. Authors: Bodil Rasmussen, PhD, RN, Senior Lecturer and Course Coordinator of Graduate Certificate of Diabetes Education and Master Courses, School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University; Glenn Ward, MBBS, DPhil, Sc, Associate Professor and Head of Diabetes Services, Departments of Endocrinology and Diabetes and Clinical Biochemistry, St Vincent’s Hospital; Alicia Jenkins, MBBS, MD, Associate Professor, Department of Endocrinology and Diabetes, University of Melbourne and Physician, St Vincent’s Hospital; Susan J King, PhD, BN, RN, Research Fellow, School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University; Trisha Dunning, PhD, AM, Professor and Inaugural Chair in Nursing, Barwon Health and Deakin University, Geelong and School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University and Barwon Health, Vic., Australia
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  • Alicia Jenkins,

    1. Authors: Bodil Rasmussen, PhD, RN, Senior Lecturer and Course Coordinator of Graduate Certificate of Diabetes Education and Master Courses, School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University; Glenn Ward, MBBS, DPhil, Sc, Associate Professor and Head of Diabetes Services, Departments of Endocrinology and Diabetes and Clinical Biochemistry, St Vincent’s Hospital; Alicia Jenkins, MBBS, MD, Associate Professor, Department of Endocrinology and Diabetes, University of Melbourne and Physician, St Vincent’s Hospital; Susan J King, PhD, BN, RN, Research Fellow, School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University; Trisha Dunning, PhD, AM, Professor and Inaugural Chair in Nursing, Barwon Health and Deakin University, Geelong and School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University and Barwon Health, Vic., Australia
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  • Susan J King,

    1. Authors: Bodil Rasmussen, PhD, RN, Senior Lecturer and Course Coordinator of Graduate Certificate of Diabetes Education and Master Courses, School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University; Glenn Ward, MBBS, DPhil, Sc, Associate Professor and Head of Diabetes Services, Departments of Endocrinology and Diabetes and Clinical Biochemistry, St Vincent’s Hospital; Alicia Jenkins, MBBS, MD, Associate Professor, Department of Endocrinology and Diabetes, University of Melbourne and Physician, St Vincent’s Hospital; Susan J King, PhD, BN, RN, Research Fellow, School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University; Trisha Dunning, PhD, AM, Professor and Inaugural Chair in Nursing, Barwon Health and Deakin University, Geelong and School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University and Barwon Health, Vic., Australia
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  • Trisha Dunning

    1. Authors: Bodil Rasmussen, PhD, RN, Senior Lecturer and Course Coordinator of Graduate Certificate of Diabetes Education and Master Courses, School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University; Glenn Ward, MBBS, DPhil, Sc, Associate Professor and Head of Diabetes Services, Departments of Endocrinology and Diabetes and Clinical Biochemistry, St Vincent’s Hospital; Alicia Jenkins, MBBS, MD, Associate Professor, Department of Endocrinology and Diabetes, University of Melbourne and Physician, St Vincent’s Hospital; Susan J King, PhD, BN, RN, Research Fellow, School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University; Trisha Dunning, PhD, AM, Professor and Inaugural Chair in Nursing, Barwon Health and Deakin University, Geelong and School of Nursing, Faculty of Health, Medicine, Nursing and Behavioural Sciences, Deakin University and Barwon Health, Vic., Australia
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Dr Bodil Rasmussen, Senior Lecturer and Course Coordinator of Graduate Certificate of Diabetes Education and Master Courses, Faculty of Health, Medicine, Nursing and Behavioural Science, School of Nursing, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia. Telephone: +61 3 92446425.
E-mail:bodil.rasmussen@deakin.edu.au

Abstract

Aim.  To identify life transitions likely to impact diabetes self-care among young adults with Type 1 diabetes and their coping strategies during transition events.

Background.  Relationships among psychosocial stress, adjustment, coping and metabolic control affect clinical outcomes and mental health. Life transitions represent major change and are associated with stress that temporarily affects individuals’ problem-solving, coping abilities and blood glucose levels.

Design.  A qualitative interpretive inquiry.

Method.  Semi-structured interviews were conducted with 20 young adults with Type 1 diabetes and a constant comparative analysis method. Data and analysis was managed using QSR© NVivo 7 software.

Results.  Participants identified two significant transition groups: life development associated with adolescence, going through the education system, entering new relationships, motherhood and the workforce and relocating. Diabetes-related transitions included being diagnosed, developing diabetes complications, commencing insulin pump treatment and going on diabetes camps. Participants managed transitions using ‘strategic thinking and planning’ with strategies of ‘self-negotiation to minimise risks’; ‘managing diabetes using previous experiences’; ‘connecting with others with diabetes’; ‘actively seeing information to ‘patch’ knowledge gaps’; and ‘putting diabetes into perspective’.

Conclusions.  Several strategies are used to manage diabetes during transitions. Thinking and planning strategically was integral to glycaemic control and managing transitions. The impact of transitions on diabetes needs to be explored in larger and longitudinal studies to identify concrete strategies that assist diabetes care during life transitions.

Relevance to clinical practice.  It is important for health professionals to understand the emotional, social and cognitive factors operating during transitions to assist young adults with Type 1 diabetes to achieve good health outcomes by prioritising goals and plan flexible, timely, individualised and collaborative treatment.

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